Reconstruction of Carpal Bone Loss of Septic Wrist Arthritis Using Induced Membrane Technique

Abstract

The induced membrane technique has been widely used for the reconstruction of the segmental bone defect. The technique requires two-stage surgery. The first surgery is debridement of the affected bone and replacement of the defect by cement spacer. The spacer is removed at the second surgery, and the defect is filled with cancellous bone. The use of the technique for septic wrist arthritis treatment has not been reported. We report two cases of septic wrist arthritis treated by the induced membrane technique. Radical debridement including the carpal bones was performed as a first surgery. The cement spacer was placed into the bone defect after first surgery; then cancellous bone was transplanted into the induced membrane several weeks later. External fixator or plate fixation was performed simultaneously. Bone formation was observed in both cases at several months after the reconstruction surgery. There was no pain or recurrence of infection in both cases. We consider this technique is a possible method for reconstruction, especially in a difficult case.